scholarly journals Assessment of osteoporosis using the FRAX method and the importance of vitamin D levels in COPD patients

2019 ◽  
Vol 13 ◽  
Author(s):  
Ceyda Anar ◽  
Melike Yüksel Yavuz ◽  
Filiz Güldaval ◽  
Dilek Kalenci

Background: The aim of this paper was to evaluate the availability of FRAX for assessing osteoporosis risk, and to demonstrate the importance of vitamin D levels in COPD patients. Methods: Fourty-six males who fulfilled the COPD diagnostic criteria defined by GOLD were included. Age, race, BMI, physical activity frequency, smoking and dietary habits, age at COPD diagnosis, disease duration, fractures history, and medications use were determined. Levels of 25(OH)D were detected. BMD was measured by DXA at lumbar spine, femoral neck, and entire femur, and classified according to ISCD. FRAX score was calculated. Control group was composed of 40 non-smoker individuals without previous history of pulmonary diseases. Results: 25(OH)D levels were significantly different between patients and controls. In the COPD group, a statistically significant difference in vitamin D levels was detected among the A, B, C, and D grades, while no such significant differences in FRAX scores were detected. 25(OH)D levels were significantly low in COPD patients with disease exacerbations and hospitalizations in the previous one year. No correlation was detected between vitamin D levels and the FRAX score. A positive correlation was observed between vitamin D levels and T-score. FRAX scores were higher and vitamin D levels were lower in osteoporotic COPD patients than in non-osteoporotic COPD patients. Conclusion: Using FRAX for assessing osteoporosis in COPD can reduce fracture risk and allow adequate treatment. Since vitamin D levels are related to exacerbations and hospitalizations, vitamin D supplementation may be needed in COPD patients, especially in those with high FRAX scores.

2021 ◽  
Vol 14 (3) ◽  
pp. 284
Author(s):  
Anna Zielińska ◽  
Aleksandra Sobolewska-Włodarczyk ◽  
Maria Wiśniewska-Jarosińska ◽  
Anita Gąsiorowska ◽  
Jakub Fichna ◽  
...  

Due to its immunomodulatory effect, vitamin D has been associated with clinical parameters and outcomes in inflammatory bowel diseases (IBDs) which are chronic conditions of the gastrointestinal tract. Upon synthesis or digestion, vitamin D is metabolized in the liver to form 25(OH)D3, the major circulating metabolite. Further renal hydroxylation generates 1,25(OH)2D3, the most potent metabolite. Our aim was to examine the association between vitamin D levels, and its supplementation and pain intensity in 39 IBD patients and 33 healthy individuals. 25(OH)D3 and 1,25(OH)2D3 serum levels were measured. Each subject filled out visual analog scale (VAS) and Laitinen’s pain assessment scales. Laboratory results were obtained, and disease activity was assessed. Linear regression was employed to investigate the correlation between 25(OH)D3, 1,25(OH)2D3 and pain intensity, clinical activity parameters, C-reactive protein, disease duration, and dietary habits. In IBD patients, 25(OH)D3 was increased, whereas 1,25(OH)2D3 was not. Vitamin D3 supplementation did not influence their levels. No correlation was found between pain scores, disease activity, inflammatory status, disease duration or dietary habits and both forms of vitamin D. Elevated 25(OH)D3 and normal 1,25(OH)D3 were found in IBD patients as compared to the controls. We discovered no effect from supplementation and no association between pain severity and vitamin D.


2018 ◽  
Vol 8 (2) ◽  
Author(s):  
Achmad Rifa’i ◽  
Handono Kalim ◽  
Kusworini Kusworini ◽  
Cesarius Singgih Wahono

Background : Low level of vitamin D impact the disease activity and the degree of fatigue in SLE patients. This study aims to determine the effect of vitamin D supplementation on disease activity and fatigue condition in Systemic Lupus Erythematosus (SLE) patients with hipovitamin D.Methods: We performed an open clinical trial. Subjects were randomized into two different groups (supplementation or placebo) using simple random sampling. The treatment group got vitamin D3 softgel/ cholecalciferol 1200 IU/day or 30 mg/day, while the control group gotplacebo for 3 months. SLEDAI scores and FSS scores were calculated at pre and posttreatment.Results: There were 20 subjectsfor supplementation group and 19 subjects in the placebo group. From this study, before and after treatment, we found a significant difference of mean level of vitamin D in supplementation group (p=0.000), and no significant difference inpatients with placebo (p=0.427). Moreover, from the SLEDAI score analysis, observed a significant difference bothin the supplemented group (p=0.000) and the placebo group (p=0.006). FSS scores significantly different in the supplemented group (p=0.000). Incorrelation test,there was a negative correlation (r=-0763) between vitamin D level and disease activity (SLEDAI), and both showing stastistical significance between thepre supplementation (p=0.000) and post supplementation (r=-0846; p=0.000). Similarly to theFSS scores, there was a meaningfulnegative correlation (r=-0.931, p=0.000) between the level of vitamin D with FSS scores pre and post supplementation (r=-0.911; p= 0.000). Furthermore, there was a significant correlation between disease activity (SLEDAI) pre supplementation with fatigue condition pre supplementation (r=0.846; p = 0.000) and postsupplementation (r=0.913; p= 0.000).Conclusion: The supplementation of vitamin D 1200 IU per day in patients with SLE improve disease activity and degree of fatigue. Keywords: vitamin D, disease activity, fatigue, SLE


2010 ◽  
Vol 43 (3) ◽  
pp. 141
Author(s):  
Sri Kentjananingsih

Background: Tooth extraction can cause alveolar resorption, and will reduce the denture retention. The process of bone resorption looks like the process of osteoporosis. Calcium and vitamin D supplementation is the rational therapy for minimizing bone loss. Miacalcic is the drug of choice for osteporotic patient. Purpose: This study is aimed to know whether the combination of miacalcic, calcium lactate, and vitamin C are effective in inhibiting post extracted alveolar resorption. Methods: Thirty three healthy postmenopausal women were chosen as samples and they were classified randomly into control group (without treatment), 1st experiment group (treatment was started 3 months post extraction), and 2nd experiment group (treatment was started at the 2nd day post extraction). The treatment was done by giving miacalcic nasal spray, calcium lactate 500 mg and vitamin C 100 mg tablets every morning in 10 days every month for 3 months. X-ray photo of the post extracted area were taken an hour, 3 months, and 6 months post-extraction. Results: After 6 month, there was significant difference in buccolingual thickness decreasing among three groups (p<0.05). The maximum mean difference of buccolingual thickness decreasing was 0.72 mm, between control and 2nd experiment groups. There was no significant difference about decreasing bone density among them (p>0.10). The maximum difference of the mean of density decreasing was 1,906 g/cm2/mm between control and 2nd experiment groups. The increasing density mostly occurred in the 2nd experiment group. Conclusion: The combination of miacalcic, calcium lactate, and vitamin C are effective for inhibiting alveolar resorption, although statistically there was no significant difference about bone density decreasing. The sooner this treatment is given the better result will be achieved.Latar belakang: Pencabutan gigi menyebabkan resorpsi tulang alveolaris, dan akan mengurangi retensi geligi tiruan. Proses resorpsi tulang alveol pada osteoporosis mirip dengan proses resorpsi tulang pada penyembuhan luka bekas pencabutan. Miacalcic adalah obat utama untuk penderita osteoporosis. Kalsium dan vitamin D merupakan terapi yang rasional untuk meminimalkan resorpsi tulang. tujuan: Membuktikan apakah kombinasi miacalcic, kalsium laktat, and vitamin C juga efektif menghambat resorpsi tulang alveol pasca pencabutan. Metode: Sampel 33 wanita postmenopause yang sehat, terbagi secara acak ke dalam kelompok kontrol (tanpa perlakuan), kelompok eksperimen 1 (perlakuan mulai 3 bulan pasca pencabutan) dan kelompok eksperimen 2 (perlakuan mulai hari kedua pasca pencabutan). Perlakuannya yaitu: pemberian miacalcic semprot hidung, tablet kalsium laktat 500 mg dan vitamin C 100 mg setiap pagi, 10 hari dalam sebulan, selama tiga bulan. Foto sinar-X dari regio pasca pencabutan dibuat satu jam, 3 bulan, dan 6 bulan pasca pencabutan. Hasil: 6 bulan pasca-cabut, ada beda bermakna perihal selisih tebal bukolingual tulang alveol antar ketiga kelompok (p<0,05). Rerata penurunan ketebalan ini maksimal sebanyak 0.72 mm, antara kelompok kontrol dan kelompok eksperimen 2. Penurunan kepadatan tulang antar ketiga kelompok tidak bermakna (p>0,10). Beda maksimum rerata kepadatan tulang antara kelompok kontrol dan kelompok eksperimen 2 sebesar 1,906 g/cm2/mm. Peningkatan kepadatan terbanyak dialami anggota kelompok eksperimen 2. Kesimpulan: Kombinasi miacalcic, kalsium laktat, vitamin C efektif menghambat resorpsi tulang alveolaris, walaupun secara statistik beda penurunan kepadatan tidak bermakna. Makin awal pemberian perlakuan, hasilnya akan lebih baik.


2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S536-S537
Author(s):  
D Vranesic Bender ◽  
V Domislović ◽  
M Brinar ◽  
D Ljubas Kelečić ◽  
I Karas ◽  
...  

Abstract Background Vitamin D deficiency is frequently present in inflammatory bowel disease (IBD) with a higher incidence in Crohn’s disease (CD) than in ulcerative colitis (UC). Given the involvement of the alimentary tract, many factors can contribute to vitamin D deficiency. The aim of the study was to investigate the association of vitamin D deficiency according to body mass index (BMI) in adult patients with IBD. Methods A cross-sectional study was conducted on a cohort of 152 IBD patients, 68.1% (n = 104) CD and 31.9% (n = 48) UC. The mean age of the total study population was 37.3±11.8 years and 57.3% (n = 87) were male. All patients were adult, Caucasian and without vitamin D supplementation. Patients were recruited during one year period. Results Out of all IBD patients, 60.5% (n = 92) had vitamin D deficiency, 32.2%, (n = 49) insufficiency and 7.2% (n = 11) sufficiency. According to BMI categories there were 12.5% (n = 19) obese patients, 27.6% (n = 42) overweight, 51.3% (n = 78) with normal body weight, and 8.6% (n = 13) underweight. There was a significant difference in vitamin D levels according to different BMI categories in terms of underweight patients having the lowest vitamin D levels; underweight 29.84±11.94 mmol/l, normal 46 ± 20.7 mmol/l, overweight 48±20.1 mmol/l, obese 51±15.3 mmol/l. In addition, there was a significant correlation of vitamin D levels and BMI values (Rho = 0.212, 95% CI 0.069–0.345, p = 0.004), which was more clearly observed in the lower range of BMI values (Figure 1). Male underweight patients had lower levels of vitamin D compared with female patients (26.6 ± 9 vs. 34.7 ± 5.6, p &lt; 0.05). Both patients with CD and UC had significant positive correlation of vitamin D levels and BMI values (UC Rho=0.40, 95% CI 0.16–0.59, p = 0.001, UC Rho = 0.27, 95% CI 0.01–0.05, p = 0.044). However, when comparing vitamin D levels according to phenotype, a significant difference in vitamin D levels was observed in underweight CD (28.4 ± 11.1) comparing to underweight UC patients (40.6 ± 10.6), p &lt; 0.05. In logistic regression analysis, CD phenotype was risk factor for vitamin D deficiency (OR 2.18 95% CI 1.01–4.72, β = 1.22, p = 0.04). Conclusion Our results on untreated IBD patients show a high proportion of vitamin D deficiency both in CD and UC, and significant correlation of vitamin D levels and BMI values, especially in the lower range of BMI values. Moreover, underweight CD patients have lower vitamin D levels comparing to UC. This suggests the need for regular vitamin D monitoring and supplementation especially in IBD patients at risk.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e20000-e20000
Author(s):  
Nurdan Tacyildiz ◽  
Gulsah oktay Tanyildiz ◽  
Deniz Tekin ◽  
Can Ates ◽  
Handan Dincaslan ◽  
...  

e20000 Background: There is increasing interest in the possible association between cancer incidence and vitamin D through its role as a regulator of cell growth and differentiation. Although there are several studies related cancer risk and prognosis of cancer, related vit D levels in adult patients there are only few recent studies in pediatric patients. Methods: Between 2010 and 2011, D Vit levels of 45 patients (25 boys, 20 girls; age range: 6 months-17 years, median: 11 years) have been compared to D Vit levels of 22 healthy children with similar age group. Patient groups were leukemias, lymphomas, bone tumors, retinoblastoma (RB), and other tumors. Kruskal-Wallis and Spearman nonparametric correlations test of SPSS has been used for statistics. Results: Although there was no statistically significant difference for vit D levels between control group (range: 7.2-22.8; median: 14.75 ng/ml) and patients (range: 5.5-40.2; median: 16.0 ng/ml),difference between patients groups were significant (Table). Patients with RB have statistically lower level of Vit D than leukemia (p:0.016) and lymphoma groups ( p: 0.047). “Other tumors group” has lower vit D levels than leukemia group (p: 0.024). Since RB and other tumors group have younger age than other patients, Spearsman’s nonparametric correlation has been performed to exclude age effect on the results and no statistically significant correlation between D vit levels and age (p: 0.779) was found, although there was an inverse correlation between age and vit D levels in patient group (p: 0.03). Conclusions: According to our preliminary results, most of the patients and healthy children have low level of Vit D. Especially patients with RB have statistically significant lower level of Vit D than other malignancies which can be subject to future studies for confirmation of our results. In addition, etiologic studies related RB may have a new area. [Table: see text]


2020 ◽  
Vol 10 (6) ◽  
pp. 7077-7084

Asthma is a chronic disease that affects the airways in the lungs and is common in many countries. Studies have shown that vitamin D levels are associated with the onset and exacerbation of asthma symptoms. Given the role of vitamin D in regulating immune responses and the importance of the two major cytokines IL-4 (an inflammatory cytokine) and IL-10 (an anti-inflammatory cytokine) in immunological processes, in this study, the relationship between vitamin D intake and the level of expression of these ILs in asthmatic mice was investigated. In the case-control study performed in three groups of mice, 10 experimental asthma mice, 10 asthmatic vitamin D-treated mice, and 10 healthy mice as the control group were studied. For analyses, after RNA extraction and cDNA synthesis, the expression level of two IL-4 and IL-10 genes was evaluated by real-time PCR. Finally, the results were analyzed by SPSS software. The results showed that in the control group, the expression level of IL-4 and IL-10 genes was 0.01 and 0.02, respectively. Accordingly, the expression level of the IL-4 gene in asthmatic mice and asthmatic mice treated with vitamin D was 0.6 and 0.2, respectively, while the expression level of the IL-10 in these groups was 1.2 and 2.8, respectively, which showed significant changes (p-value < 0.05) in treated mice compared to the asthmatic mice without treatment. Based on results, in asthmatic mice treated with vitamin D, a significant increase in IL-10 expression was observed (1.2 to 2.8), while IL-4 expression was decreased from 0.6 to 0.2. It appears that vitamin D supplementation in asthmatic patients by affecting T-cell maturation and increasing anti-inflammatory IL-10 and suppressing IL-4 may play a role in reducing the symptoms of asthma.


2021 ◽  
pp. 201010582110414
Author(s):  
Amin R. Soliman ◽  
Tarek Samy Abdelaziz ◽  
Ahmed Fathy

Background Coronavirus disease-19 (COVID-19) is an ongoing pandemic causing considerable fatalities worldwide. Vitamin D modulates the immune response through effects on various cells, such as: macrophages, B and T lymphocytes, neutrophils, and dendritic cells. Aim To explore whether supplementation of vitamin D, in the form of a single intramuscular cholecalciferol injection, to patients with diabetes, COVID-19, and low vitamin D levels could improve the prognosis of those patients. Methods This was a placebo-controlled randomized prospective study. The study has two arms as follows: the intervention arm (40 vitamin D deficient diabetes elderly patients that acquired SARS-CoV-2), compared to the control arm (16 elderly diabetes patients, with deficient vitamin D with SARS-CoV-2). Patients in the intervention arm were given vitamin D as a single intramuscular injection (200,000 IU); patients in the control arm were given placebo. The primary outcome was mortality within 6 weeks of the diagnosis of COVID-19. Clinical, laboratory, treatment, and outcome data were recorded after 6 weeks of follow-up. Results No significant difference in 6 weeks mortality was observed between patients who received vitamin D and patients who received placebo (17.5% vs 18.8%, p = 0.838). Age, presence of hypertension, and chronic obstructive pulmonary disease were independent predictors of mortality at 6 weeks. Conclusion Vitamin D supplementation did not reduce the severity or mortality of COVID-19 at 6 weeks. Further large scale studies are required to explore the effect of vitamin D therapy on survival in patients with diabetes mellitus who acquire COVID-19.


2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Yasir Iqbal Malik ◽  
Aqsa Malik ◽  
Rabbia Shabbir ◽  
Atteaya Zaman ◽  
Sohail Zia ◽  
...  

Purpose: To determine the levels of Vitamin D in children with myopia and to compare them with age matched controls. Study Design:  Case control study. Place and Duration of Study:  The study was conducted in Naseer Memorial Hospital, Dadhyal Azad Kashmir from March 2016 to March 2017. Material and Methods:  Two hundred patients were selected using convenient sampling technique and were divided two groups (group I Myopic and group II control). Myopia was labeled if after subjective refraction a Spherical Equivalent (SE) of −0.50 diopters (D) or more was found. Vitamin D levels were measured by radioimmunoassay technique with Diasorin SR® kit following the user’s manual. Vitamin D levels less than 20 ng/ml were considered Vitamin D deficient following the standards of American academy of pediatrics. The collected data was entered in the statistical package for social sciences (SPSS) version 21 for analysis. Independent t–test was used to determine the significant difference of means between controls and patients. P-values less than 0.05 were considered significant. Results:  Mean age of controls and myopes were 10.65 ± 3.9 and 10.20 ± 2.5 years respectively. Vitamin D levels in myopic children were found to be 14.95 ± 3.75 ng/ml and there was no significant difference in mean values of Vitamin D levels in myopic and control group. Conclusion:  We found no difference in Vitamin D levels of myopic and non myopic children and concluded that Vitamin D has no role in development or progression of myopia.


Author(s):  
Beyza Genç Çetin ◽  
Taşkın Şentük ◽  
Neriman Aydın

Introduction: Systemic lupus erythematosus (SLE) is a multisystemic, autoimmune connective tissue disease characterized by a variable course and prognosis. We aimed to determine IL-10, IL-17 and IL-23 cytokines and vitamin D levels in SLE patients, which we think play role in the pathogenesis of the disease. Material and Method: Forty SLE patients and 20 healthy controls were included in our study. Levels of IL-10, IL-17 and IL-23 were measured by sandwich ELISA method. Quantitative data are expressed as mean ± standard deviation and median range (maximum-minimum) values. The data were analyzed at 95% confidence interval, and cases where the p value was less than 0.05 were considered statistically significant. Results: IL-10 and IL-17 levels of the control and patient groups were compared and no statistically significant difference was found (p=0.333, p=0.99). IL-23 levels of the patient group were found to be higher than the control group and were found to be statistically significant (p<0.001). No statistically significant relationship was found between disease duration or SLEDAI score and IL-23 levels (p=0.476). 25 (OH) vitamin D levels of the patient group were found to be lower than the control group and were statistically significant (p=0.003). No significant relationship was found between IL-10 and IL-17 levels and vitamin D. Significant relationship was found between IL-23 and vitamin D levels (p=0.019). Discussion: In our study, there was no significant difference between the groups in terms of IL-10 or IL-17, while IL-23 levels were found to be significantly higher in SLE patients. Vitamin D levels were found to be lower in the patient group with SLE compared to the control group, and a negative correlation was found between the disease duration and IL-23. Specific blocking of the IL-23 immune pathway can be an effective and safe treatment option in the treatment of SLE.


2015 ◽  
Vol 3 (4) ◽  
pp. 21-25
Author(s):  
Taru Gupta ◽  
Nupur Gupta ◽  
Leena Wadhwa ◽  
Sarika Arora ◽  
Jyoti Bagla ◽  
...  

INTRODUCTION: Obesity is associated with alteration in the vitamin D levels and has been related to vitamin D status. Lower vitamin D levels in higher BMI individuals may be secondary to an alteration in tissue distribution resulting from an increase in adipose mass. Therefore women with higher BMI need higher vitamin D supplementation as compared to women with BMI within normal range.  MATERIAL AND METHOD: This was a case control study carried out in Department of Obstetrics and Gynaecology, ESIC-PGIMSR, New Delhi from August 2012-April 2014. A total of 100 patients were divided into two equal groups (control and study groups of 50 each). Control group had women with singleton uncomplicated term normotensive pregnant women in labour while the study group comprised of term preeclamptic women in labour.In all the patients their BMI was analysed .Blood samples for vitamin D, serum calcium, serum phosphorus, serum parathormone, serum alkaline phosphatase levels were drawn and subsequently their levels were evaluated in cord blood; correlation studied between vitamin D & BMI. RESULTS: The mean BMI was relatively higher in the study group (26.34 ± 4.12)kg/m2 than in the control group ( 24.24 ± 3.13)kg/m2. Thus in our study a prevalence of higher BMI was seen in patients of preeclampsia. When all the 100 women are being considered, median vitamin D levels were found to be higher (6.6ng/ml) in normal BMI patients (n=55) as compared to levels (5.6ng/ml) in patients with higher BMI(n=45).  CONCLUSION: Vitamin D levels are related to maternal body mass index. Individuals with higher percentage body fat may require higher vitamin D intake to attain optimal 25(OH) D levels, compared with lean individuals and thereby may prevent pregnancy complications like Pre eclampsia.


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